肺表面活性物质及鼻塞式CPAP早产儿肺透明膜病的治疗探讨

目的:评价鼻塞式CPAP加肺表面活性物质(Curosurf)对早产儿肺透明膜病的治疗作用,并与常规的机械通气做比较。方法:27例患肺透明膜病的早产儿经气管内滴入Curosurf(100mg/kg),然后拔管予鼻塞式CPAP呼吸支持治疗,与25例常规的机械通气病例比较两组患儿的临床症状、体征及血气变化、并发症、住院时间以及住院费用。结果:治疗后1h,患儿症状、体征明显好转,6h、12h及24h,两组患儿的血气较治疗前显著改善,两组比较,无明显差异。而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组,氧疗及住院时间明显少于机械通气组,而且住院费用也较低。结论:鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有治疗效果好,并发症及住院时间少,住院费用少等特点。

Probe in the therapeutic effect of pulmonary surfactant and nasal CPAP on prematures with pulmonary hyaline membrane disease

Objective:To value the effect of nasal CPAP and surfactant (curosurf) on neonates with pulmonary hyaline membrane disease,and compared with that of conventional ventilation.Methods:27 cases with hyaline membrane disease were given curosurf by intraluminal (100 mg/kg), then extubated to nasal CPAP, blood gas after treatment, complications,hospitalization and fees were compared with those of 25 cases treated with surfactant and conventional ventilation. Results:Blood gases improved by the time of 6,12,24 hours after treatment in the two groups without significant difference between the two groups. The rates of lung infection and chronic lung disease in CPAP group were lower than that of conventional ventilation group, the duration in oxygen and hospitalization were also shorter in CPAP group than those in conventional ventilation group, and the fee in CPAP group were lower than that of conventional ventilation group, there were significant differences between two groups. Conclusion:Hyaline membrane disease improved after treated by nasal CPAP and surfactant, less babies had repiratory infection and chronic lung disease in CPAP group compared with those in conventional ventilation, and the duration of oxygenation and hospitalization in CPAP group were also shorter than those in conventional ventilation group.